Santa Cla lara County, CA A Retrospective Study 2011-2016 Kari - - PowerPoint PPT Presentation

Homeless Deaths in in Santa Cla lara County, CA A Retrospective Study 2011-2016

Kari arin Wells ls, BA, , Stu Student In Intern for

• r the Chie

Chief Medic ical l Ex Examiner Mic ichelle A. . Jor Jorden, , MD, , Ch Chie ief Medical Ex Examiner Sa Santa Clar Clara Co County Medical Ex Examiner-Coroner’s Office

METHOD AND PROJECT OUTLINE

• Each year, from 2011 through 2016, was analyzed for
• Demographics
• Cause and manner of death
• Location of death
• Medical history
• Drug use
• Veteran status
• Motor vehicle related deaths
• Each case file was reviewed, number of deaths verified, and variables

analyzed by the Chief Medical Examiner Michelle A. Jorden, MD, Interim Chief Investigator Rosa Vega, and student intern Karin Wells

HOMELESSNESS

• The Medical Examiner-Coroner’s Office determine homelessness if the

circumstances of the death occurred in an environment to suggest homelessness (e.g. homeless encampment) or the decedent was known to be homeless and/or public record searches do not identify a valid living address

20 40 60 80 100 120 140 2011 2012 2013 2014 2015 2016

NUMBER OF DECEDENTS YEAR

HOMELESS DEATHS IN SANTA CLARA COUNTY 2011-2016

• There were 50 homeless deaths in Santa Clara County in 2011, followed by 62 in 2012, 78 in 2013, 69

in 2014, 85 in 2015, and 132 in 2016.

• Between 2011 and 2016, the number of homeless deaths increased by 164%.

TOTAL HOMELESS DEATHS 2011-2016

DEMOGRAPHICS: SEX

Male 83% Female 17%

SEX

Male Female

DEMOGRAPHICS: ETHNICITY

58% 26% 8% 4% 1% 1% 0% 1% 1% 0%

ETHNICITY

Caucasian Hispanic Black Asian Pacific Islander Native American East Indian Middle Eastern Other Unknown

DEMOGRAPHICS: AGE

Year Age (in years) 2011 53 2012 47, 55, 57 2013 46, 49, 52 2014 58 2015 53 2016 62

AGE AT DEATH

• There were two fetal demises during the six year period.

LOCATION OF DEATH

20 40 60 80 100 120 140 160 180 Indoor Makeshift Living Area Outdoor Makeshift Living Area Outdoors (not living there) Hospital/ER/Nursing Facility Indoors (other) Hotel/Motel Other Residence Homeless Shelters NUMBER OF DECEDENTS LOCATION

LOCATION OF DEATH 2011-2016

THE AGING HOMELESS POPULATION

5 10 15 20 25 2011 2012 2013 2014 2015 2016

NUMBER OF DECEDENTS YEAR

DECEDENTS 65 AND OVER 2011-2016

MANNER OF DEATH

50 100 150 200 250 Natural Accident Undetermined Suicide Homicide Pending NUMBER OF DECEDENTS MANNER

MANNER OF DEATH 2011-2016

TOTAL DEATHS PER SEASON

20 40 60 80 100 120 140 2011 2012 2013 2014 2015 2016 NUMBER OF DECEDENTS YEAR

DEATHS PER SEASON 2011-2016

Winter Spring Summer Fall

HOMELESS VETERANS

1 2 3 4 5 6 7 8 9 10 2011 2012 2013 2014 2015 2016

NUMBER OF DECEDENTS YEAR

VETERANS 2011-2016

CAUSES OF DEATH: VEHICLE ACCIDENTS

2 4 6 8 10 12 14 2011 2012 2013 2014 2015 2016

NUMBER OF DECEDENTS YEAR

VEHICLE ACCIDENTS AS CAUSE OF DEATH 2011-2016

CAUSES OF DEATH: DRUGS AND ALCOHOL

5 10 15 20 25 30 2011 2012 2013 2014 2015 2016 NUMBER OF DECEDENTS YEAR

CAUSE OF DEATH DUE TO DRUG/ALCOHOL INTOXICATION 2011-2016

5 10 15 20 25 30 35 40 45 2011 2012 2013 2014 2015 2016

NUMBER OF DECEDENTS YEAR

PRESENCE OF METHAMPHETAMINE AND ALCOHOL

Alcohol Methamphetamine

MENTAL ILLNESS

5 10 15 20 25 2011 2012 2013 2014 2015 2016 NUMBER OF DECEDENTS WITH A MENTAL ILLNESS YEAR

MENTAL ILLNESS 2011-2016

STRESSORS PRIOR TO DEATH

5 10 15 20 25 30 2011 2012 2013 2014 2015 2016 NUMBER OF DECEDENTS YEAR

RECENT STRESSORS

Emotional Medical Altercations (physical and verbal) Law Enforcement

HIGHLIGHTS

• The number of homeless deaths in Santa Clara County increased 164% over the six

year period. Between 2011 and 2016, the homeless population rose, with the greatest number of deaths occurring in 2016.

• Homeless deaths were more common among males than females, with Caucasians

being the most predominantly represented ethnic group.

• Alcohol and drug abuse continues to claim a significant number of homeless

deaths each year with alcohol and methamphetamine being the most commonly abused drugs. Heroin deaths are being monitored given the opioid epidemic.

• The number of elderly deaths over the age of 65 years has risen and is expected to

rise given the aging baby boomer population.

• A significant percentage of the homeless are continuing to die in homeless

encampments and on the streets with zip codes 95128 and 95116 being the hot spots currently identified for these deaths.

RECOMMENDATIONS

• Homelessness is a complex and multifactorial social issue as exemplified in this study. Access to

consistent medical and mental health care services, as well as drug and alcohol services and employment resources are underscored.

• The combination of drug and alcohol intoxication was shown to be the most prevalent lethal factor
• ver the entire study period. Ensuring that the homeless population has consistent access to drug

and alcohol intervention services is warranted.

• The current opioid epidemic can affect the homeless population including access to synthetic
• pioids. The distribution and use of Narcan (naloxone) should be considered in this population to

prevent overdoses.

• With an increase of baby boomers becoming older, preventive healthcare in the form of vaccines

(pneumonia/shingles), as well as treating chronic medical conditions such as hypertension and diabetes is underscored for this population.

• The homeless population, like anyone, may be involved in relationships with others or pets that

cannot be easily separated or accommodated in shelters or other facilities. We must remember and be sensitive to these, as well as transgender and LGBTQ issues that may affect this population.

ACKNOWLEDGEMENTS

Deputy Public Defender Andrew Gutierrez

County of Santa Clara

Interim Chief Medical Examiner-Coroner Investigator Rosa Vega

Santa Clara County Medical Examiner-Coroner’s Office